Data currently captured for active trachoma following school screening are summarised by staff undertaking screening and then provided to relevant trachoma surveillance units. Some local systems involve capture of data related to individual children and the recording of these data on a local clinical information system. The aggregated nature of the screening data was discussed with stakeholders. Whilst there are some limitations with the summarised data provided, stakeholders generally considered that the data collected were sufficient to meet the key objectives for the screening program. Capture of de-identified person level data was not considered to be necessary at this stage. If implemented according to current guidelines, the data captured on the results of screening for active trachoma and facial cleanliness are adequate to allow estimation of prevalence, guide subsequent actions and allow the effectiveness of the program to be monitored over time.

Data are also currently captured on provision of antibiotic treatment, but there are limitations with the current national forms. National Form 1 captures data on the number of children receiving azithromycin for active trachoma within two weeks of screening. However, the form does not allow the capture of data on children screened who received treatment outside this period. National Form 2 captures data on treatment of household and community contacts (not necessarily the index child) with azithromycin. This form separately captures data on those treated within two weeks and the total number treated (including those treated outside the two week window). However, it is not clear that Form 2 will always capture children screened as well. It would be preferred to enhance National Form 1 to allow for reporting of the total number of children screened who received azithromycin (including those treated outside the two week window).

R12: It is recommended that National Form 1 be amended to capture data on the total number of children screened who received azithromycin for active trachoma by age group (including those who received treatment outside the two week period).top of page

Data are captured on health promotion and environmental interventions in communities where active trachoma has been identified on National Form 3. This form allows for a textual description of activities grouped by Surgery, Antibiotics, Facial Cleanliness, Environmental and Other. Respondents are also able to comment on the ‘completeness of implementation’ and ‘intersectoral partnerships’. In the national report these strategies are reported on by identifying communities in which:

  • programs are reported and have been implemented;
  • programs are reported but have not been implemented;
  • it is indicated that no programs have been implemented;
  • the respondent does not know if programs exist; and
  • no response has been provided.
Reporting of this nature does not appear to be very helpful in understanding exactly what types of interventions have been implemented. There is the potential to improve reporting by further codifying responses. For example, codes for different types of health promotion strategies to address facial cleanliness could be developed and respondents asked to identify the types of strategies that are being implemented. Similarly codes for different types of health promotion/education interventions could also be developed. These codes are best developed through an analysis of programs currently reported in textual form through National Form 3. Form 3 can then be modified so that data are collected in codified form.

R13: It is recommended that National Form 3 be amended to capture codified information related to the nature of health promotion strategies implemented under the facial cleanliness and the health promotion/education categories. A set of codes describing the range of health promotion/education programs should be developed through an analysis of programs currently reported in textual form through National Form 3.

The evaluators believe that an important aspect of evaluating trachoma control activities should be the tracking of information on housing and environmental conditions in communities. It is unreasonable to expect staff involved with screening to be able to collect this information themselves. Therefore, systems should be established for collating this information from other available sources. At the national level key housing and environmental indicators are available from the CHIN survey. These data are updated every five years, and are considered to be comprehensive and authoritative. OATSIH should obtain approval to access the CHIN data for use in the national trachoma surveillance system and the NTSRU should incorporate the data into the Access database. Through this arrangement data on housing and environmental conditions will be available for national reporting, for analysis at the jurisdictional level (including for identification of ‘at risk’ communities) and also potentially for feedback of information to the community level.

R14: It is recommended arrangements be made at the national level to allow relevant data from the Community Housing and Infrastructure Needs Survey (CHIN) by the year (2006 and 2011 when available) to be integrated into the national Access database on trachoma surveillance (or its replacement).

The data collection form for trichiasis screening (National Form 4) is adequate to capture relevant information on adults screened. The main issues for trichiasis screening is the establishment of systems for undertaking screening itself (see section 5.1.2). Data on patients receiving surgery for trichiasis is also collected on National Form 4. These data are very poorly collected at present. However, the main issue is the systems for collecting the data rather than the data to be collected.

There is currently no systematic approach to collecting data on community/patient satisfaction data, even though this has been identified as one of the objectives for the national surveillance system. The evaluators believe that the collection of such data is not a priority within the surveillance program but could be an area to be investigated if and when an evaluation of the national trachoma program is undertaken. top of page